Chlamydophila pneumoniae myopericarditis in a child.
An 11-year-old boy with serologically confirmed Chlamydophila pneumoniae infection presented with clinical, laboratory, and echocardiographic changes consistent with myopericarditis. No reports on C. pneumoniae myopericarditis in children are found in the medical literature. The boy, previously healthy, presented with fever, rash, constitutional symptoms, elevated acute phase reactants, elevated cardiac enzymes, and high brain natriuretic peptide levels. Hemodynamic instabilities, including hypotension and mild hypoxia, were noted. Two-dimensional echocardiographic findings showed mildly depressed left ventricular systolic function and small pericardial effusion. Requiring inotropic support, the boy was treated with azithromycin 10 mg/kg once daily for 7 days and a single dose of intravenous immunoglobulin 2 g/kg. He recovered fully with improved left ventricular systolic function before hospital discharge. An early definitive diagnosis is essential to knowing the etiology of pediatric myocarditis. Specific therapy may play role in the management and prognosis of this disorder.
Suesaowalak
Monnipa
M
Pediatric Cardiac Surgery Foundation, Institute of Cardiovascular Disease, Rajvithi Hospital, Rajthevee, Bangkok, Thailand. smonnipa@hotmail.com
Cheung
Michele M
MM
Tucker
Dawn
D
Chang
Anthony C
AC
Chu
James
J
Arrieta
Antonio
A
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000032:analysis; D017963:Azithromycin / Q000627:therapeutic use; D002648:Child; D023521:Chlamydophila Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D016993:Chlamydophila pneumoniae / Q000276:immunology / Q000302:isolation & purification*; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004452:Echocardiography; D005500:Follow-Up Studies; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D009205:Myocarditis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D010493:Pericarditis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D017963:Azithromycin